Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.44 / $74.44 / $74.44	Facility		$74.44	$74.44	$74.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.45 / $75.84 / $216.30	Professional		$70.45	$75.84	$216.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.56 / $162.32 / $268.56	Facility		$147.56	$162.32	$268.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.44 / $137.22 / $181.49	Professional		$131.44	$137.22	$181.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.15 / $315.77 / $315.77	Facility		$106.15	$315.77	$315.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.71 / $311.55 / $615.80	Facility		$83.71	$311.55	$615.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.11 / $213.75 / $279.26	Professional		$61.11	$213.75	$279.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.44 / $117.47 / $169.69	Facility		$74.44	$117.47	$169.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $144.04 / $147.56 / $177.07	Professional		$144.04	$147.56	$177.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $147.56 / $688.05	Facility		$75.00	$147.56	$688.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.22 / $79.12 / $167.35	Professional		$67.22	$79.12	$167.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $102.52	Professional		$50.00	$65.00	$102.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $74.44 / $118.05 / $169.69	Facility		$74.44	$118.05	$169.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $144.04 / $147.56 / $177.07	Professional		$144.04	$147.56	$177.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.56 / $227.09 / $395.46	Professional		$147.56	$227.09	$395.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.71 / $288.20 / $688.05	Facility		$83.71	$288.20	$688.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.11 / $83.71 / $743.07	Professional		$61.11	$83.71	$743.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.56 / $147.56 / $147.56	Professional		$147.56	$147.56	$147.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.56 / $147.56 / $147.56	Professional		$147.56	$147.56	$147.56
United Facility/Professional Facility Modifier Low / Median / High Price $0.11 / $65.33 / $76.91	Facility		$0.11	$65.33	$76.91
United Facility/Professional Professional Modifier Low / Median / High Price $54.94 / $76.91 / $160.66	Professional		$54.94	$76.91	$160.66